{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:44:24Z","timestamp":1793259864765,"version":"4.5.0"},"reference-count":36,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,11,12]]},"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare outcomes following totally transanal endorectal pull-through (TTERPT) versus pull-through with any form of laparoscopic assistance (LAPT) for infants with uncomplicated Hirschsprung's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Five hospitals with a paediatric surgical service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>405 infants with uncomplicated Hirschsprung's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>TTERPT versus LAPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary outcomes: mortality, postoperative enterocolitis, faecal incontinence, constipation, unplanned laparotomy or stoma formation, and injury to abdominal viscera.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Secondary outcomes<\/jats:title>\n                    <jats:p>Haemorrhage requiring transfusion of blood products, abscess formation, intestinal obstruction, intestinal ischaemia, enteric fistula formation, urinary incontinence or retention, impotency and duration of procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five eligible studies comprising 405 patients were identified from 2107 studies. All studies were retrospective case series, with variability in outcome assessment quality and length of follow-up. Operative duration was 50.29\u2005min shorter with TTERPT (95% CI 39.83 to 60.74, p&lt;0.00001). There were no significant differences identified between TTERPT and LAPT for incidence of postoperative enterocolitis (OR=0.78, 95% CI 0.44 to 1.38, p=0.39), faecal incontinence (OR=0.44, 95% CI 0.09 to 2.20, p=0.32) or constipation (OR=0.84, 95% CI 0.32 to 2.17, p=0.71).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta-analysis did not find any evidence to suggest a higher rate of enterocolitis, incontinence or constipation following TTERPT compared with LAPT. Further long-term comparative studies and multicentre data pooling are needed to determine whether a purely transanal approach offers any advantages over a laparoscopically assisted approach to rectosigmoid Hirschsprung's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>PROSPERO registry- CRD42013005698.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-006063","type":"journal-article","created":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T01:16:35Z","timestamp":1427246195000},"page":"e006063","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":72,"title":["Laparoscopic assistance for primary transanal pull-through in Hirschsprung's disease: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"5","author":[{"given":"David","family":"Thomson","sequence":"first","affiliation":[{"name":"National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Allin","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-May","family":"Long","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Bradnock","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Royal Hospital for Sick Children, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Royal Hospital for Sick Children, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,3,24]]},"reference":[{"key":"2025121603013174000_5.3.e006063.1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jpedsurg.2006.09.024","article-title":"Historic milestones of Hirschsprung's disease (commemorating the 90th anniversary of Professor Harald Hirschsprung's death)","volume":"42","author":"Skaba","year":"2007","journal-title":"J Pediatr Surg"},{"key":"2025121603013174000_5.3.e006063.2","first-page":"212","article-title":"Resection of rectum and rectosigmoid with preservation of the sphincter for benign spastic lesions producing megacolon; 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